Peter Giacomazzi, MD,LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

419853 Issued in CT

Legal business name

PETER GIACOMAZZI, MD,LLC

Practice address

503 Wolcott Rd
Wolcott, CT 06716-2673

Phone

(203) 879-8003

Fax

(203) 879-8010

NPI assigned

Jul 26, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Peter Giacomazzi, M.D.NPI 1710935564

Title

MD/Owner

Phone

(203) 879-8003

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Peter Giacomazzi, MD

  • Internal Medicine Physician
  • Wolcott, CT
  • NPI 1710935564
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1374796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374796800000",
    "number": "1861834210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 WOLCOTT RD",
            "city": "WOLCOTT",
            "state": "CT",
            "postal_code": "067162673",
            "telephone_number": "203-879-8003",
            "fax_number": "203-879-8010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 WOLCOTT RD",
            "city": "WOLCOTT",
            "state": "CT",
            "postal_code": "067162673",
            "telephone_number": "203-879-8003",
            "fax_number": "203-879-8010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER GIACOMAZZI, MD,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-26",
        "last_updated": "2013-07-26",
        "status": "A",
        "authorized_official_last_name": "GIACOMAZZI",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "203-879-8003",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "419853",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001419531",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Wolcott, CT
• Providers in Wolcott, CT by specialty
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.